Using Deep Learning to Predict Treatment Response in Patients with Hepatocellular Carcinoma Treated with Y90 Radiation Segmentectomy.

Treatment of hepatocellular carcinoma (HCC) with Y90 radioembolization segmentectomy (Y90-RE) demonstrates a tumor dose–response threshold, where dose estimates are highly dependent on accurate SPECT/CT acquisition, registration, and reconstruction. Any error can result in distorted absorbed dose di...

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Publicado en:Journal of Digital Imaging Vol. 36; no. 3; pp. 1180 - 1189
Autores principales: Wagstaff, William V., Villalobos, Alexander, Gichoya, Judy, Kokabi, Nima
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Jun2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10278-022-00762-0
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        atl: Using Deep Learning to Predict Treatment Response in Patients with Hepatocellular Carcinoma Treated with Y90 Radiation Segmentectomy.
      aug:
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          Wagstaff, William V.
          Villalobos, Alexander
          Gichoya, Judy
          Kokabi, Nima
        affil: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
      sug:
        subj:
          Carcinoma, Hepatocellular Diagnosis
          Carcinoma, Hepatocellular Radiography
          Deep Learning
          Treatment Outcomes
          Radiography, Interventional
          Dosimetry
          Embolization, Therapeutic
          Liver Neoplasms Radiotherapy
          Radioembolization
          Lumpectomy
          Dose-Response Relationship
          Retrospective Design
          Magnetic Resonance Imaging
          Algorithms
          Machine Learning
          Pneumonectomy
          Radioisotopes
          Data Analysis Software
          Descriptive Statistics
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Radioisotopes Therapeutic Use
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Treatment of hepatocellular carcinoma (HCC) with Y90 radioembolization segmentectomy (Y90-RE) demonstrates a tumor dose–response threshold, where dose estimates are highly dependent on accurate SPECT/CT acquisition, registration, and reconstruction. Any error can result in distorted absorbed dose distributions and inaccurate estimates of treatment success. This study improves upon the voxel-based dosimetry model, one of the most accurate methods available clinically, by using a deep convolutional network ensemble to account for the spatially variable uptake of Y90 within a treated lesion. A retrospective analysis was conducted in patients with HCC who received Y90-RE at a single institution. Seventy-seven patients with 103 lesions met the inclusion criteria: three or fewer tumors, pre- and post treatment MRI, and no prior Y90-RE. Lesions were labeled as complete (n = 57) or incomplete response (n = 46) based on 3-month post treatment MRI and divided by medical record number into a 20% hold-out test set and 80% training set with 5-fold cross-validation. Slice-wise predictions were made from an average ensemble of models and thresholds from the highest accuracy epochs across all five folds. Lesion predictions were made by thresholding all slice predictions through the lesion. When compared to the voxel-based dosimetry model, our model had a higher F1-score (0.72 vs. 0.2), higher accuracy (0.65 vs. 0.60), and higher sensitivity (1.0 vs. 0.11) at predicting complete treatment response. This algorithm has the potential to identify patients with treatment failure who may benefit from earlier follow-up or additional treatment.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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